Jan Henderson, PhD – Medical Historian and Blogger (Part 1 of 3)

August 16, 2010

Jan Henderson is a medical historian and the editor of the thoughtful, well-written blog The Health Culture. We recently had a chance to get her thoughts on some of the ongoing developments in medical blogging and the healthcare delivery system.

Where are you from?

I was born outside Boston, but lived in California until college, when I returned east. I lived in Massachusetts, Connecticut, New York, and New Jersey until fifteen years ago, when I returned to northern California.

Where did you go to school and what was your academic major?

I was an undergraduate at Harvard, where I majored in math. I have a PhD from Yale in the history of science and medicine.

What has been your career path from your last educational schooling endeavor and now?

After getting my doctorate, I taught the history of science and medicine at Queens College, CUNY. When budget cuts eliminated the non-tenured faculty positions in my department, I spent a year as a fellow at the Institute for Advanced Study in Princeton.

I was offered a teaching position on the west coast, but wasnâ€™t ready to leave New York.

Since then Iâ€™ve alternated between writing about what truly interests me and earning a living. Iâ€™ve published two books, spent time at a media industry publication, evaluated mainframe artificial intelligence software, and managed technical documentation and marketing in the personal computer industry.

I left the corporate world in 2000 and spent several years teaching traditional Chinese medicine.

What do you see as the mission of your blog?

I started blogging because I wanted to understand something that changed medicine and ideas about health in the 1970s.

Prior to that time, the policies of the Kennedy and Johnson administrations had assumed the state should be responsible for the health of its citizens.

When political and economic thinking became more conservative in the 1970s and 1980s, governments began to promote the idea that individuals were personally responsible for their health and should practice healthy lifestyles.

A large segment of the population â€“ mainly the educated and economically secure â€“ welcomed these ideas. Feeling personally responsible for oneâ€™s health and practicing healthy lifestyles gives one the reassuring illusion of control.

In particular, itâ€™s a good distraction from the things that are beyond individual control, like salmonella in our peanut butter and the superbug MRSA at the gym.

I was caught up in the healthy lifestyles attitude myself. When I look back, I could kick myself for not recognizing what was going on.

Public opinion could have been rallied to support those health issues that need government backing â€“ workplace safety, a healthy environment, an equitable distribution of access to affordable health care.

But politics took a different path and the public went jogging.

I have nothing against healthy behavior and the concept of prevention. What bothers me is misleading the public for political purposes.

Aside from smoking, the evidence for changing behavior is slim â€“ either it doesnâ€™t last (obesity) or, in some cases, it turns out to be wrong (all fats are unhealthy, fruits and vegetables prevent cancer, HRT).

I guess my mission is to be alert and not get fooled again. By writing about whatâ€™s currently happening in health and medicine, Iâ€™m collecting pieces of a puzzle.

Itâ€™s always hard to see the big picture in the moment, but eventually the pieces add up. Also, while history never repeats itself exactly, looking back at the history of medicine provides clues to the present.

Why don’t you accept advertising on your site?

I have nothing against advertising per se. I had Google ads on my blog until May 1, when I changed blogging softwares. For the moment Iâ€™m enjoying the uncluttered look.

I find online advertising objectionable when thereâ€™s a conflict of interest. I would question the health advice of Dr. Andrew Weil, given the intensity of his sales pitch.

And while WebMD may be a reliable source of information on some health matters, itâ€™s not free to be objective about issues of interest to a prospective cosmetic surgery client.

What medically related blogs do you read?

Iâ€™m afraid this is a rather long list. Iâ€™m not a specialist when it comes to medicine.

I read KevinMD, of course. Not only does it cover the current issues in medicine and health care, but it gives an inside look at what physicians and other health care professionals are thinking.

During the debate on health care legislation, my favorite sites were Health Beat by Maggie Mahar and GoozNews by Merrill Goozner. Both are experienced journalists and insightful bloggers.

For the pharmaceutical industry, I read Ed Silverman at Pharmalot. He attracts a large number of readers from both inside and outside the industry, and they leave highly educational comments.

For news on health care and pharma, as well as a look at how those inside the industry see things, I read FierceHealthcare and FiercePharma.

For an analysis of health news I read Behind the Headlines from the UKâ€™s National Health Service. They present the science â€“ or lack of it â€“ behind outrageous and distorted headlines. Health news is pretty much the same in the US and the UK, although the slight differences are interesting.

Another UK site I appreciate is Bad Science by the physician Ben Goldacre, author of a book by the same name. The things that make him angry are definitely worth being angry about.

On medical journalism, Gary Schwitzer deserves a medal. His blog is called Health News Review. He also has a website where he systematically analyzes and rates health reporting.

On bioethics, the Hastings Center has a Bioethics Forum, plus there are many other resources on their website.

Dr. Maurice Bernstein runs a Bioethics Discussion Blog. He usually cites an article and then poses a question to his readers. Some of the threads are fascinating, like the one on how readers feel about seeing a male or female physician.

That topic gets so many responses that Bernstein has to close the thread and allow a cooling off period before reopening the discussion. The comments were an eye-opener for me.

On nutrition, food safety, the FDA, and the food industry, I read Marion Nestle. She blogs for the Atlantic and has her own website, Food Politics.

Maryn McKenna wrote an excellent book on community-acquired MRSA, and I rely on her blog Superbug for updates on antibiotic resistance. Sheâ€™s a medical journalist who understands the technicalities and explains them clearly.

On psychiatry, thereâ€™s the Carlat Psychiatry Blog by Dr. Daniel Carlat. I thought his latest book (Unhinged) could have been more objective.

Understandably he defends his profession, whereas I think thereâ€™s good evidence anti-depressants have been overprescribed or prescribed for the wrong reasons. But he definitely raises and discusses the issues in psychiatry today.

Thaddeus Pope writes on the ethical and legal issues raised by the ability of modern medicine to keep us alive, both at the end and the beginning of life. His blog is called Medical Futility. Heâ€™s a law professor.

I really enjoy a relatively new blog on geriatrics and palliative care called GeriPal. Itâ€™s written and frequented by a very nice group of people.

I also read another excellent blog on hospice and palliative medicine thatâ€™s been around for years: Pallimed. These are professionals who deal with end-of-life issues every day.

Finally, for fun and inspiration I read Street Anatomy â€“ a daily illustration of the use of anatomy in art, advertising, fashion, commercial products, and street life.